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Swedish Study Suggests Threshold for Further PSA Screening After Age 60 — Physician’s First Watch

Swedish Study Suggests Threshold for Further PSA Screening After Age 60

By Kelly Young

Prostate-specific-antigen (PSA) screening after age 60 should focus on men with PSA levels at or above 2 ng/mL, according to a BMJ study.

Nearly 1800 Swedish men who received baseline PSA screening at age 60 were compared with an unscreened cohort of 1200 men whose PSA levels were assessed retrospectively through blood samples they provided at age 60.

Overall, screened men had more prostate cancer diagnoses than unscreened men at 15 years, but there was no difference in cancer-related mortality or metastasis. Only men with PSA levels of 2 ng/mL or higher saw a mortality benefit — 23 men needed to be screened and 6 needed to be diagnosed to prevent one prostate-cancer death by 15 years.

The authors conclude: "For men with a PSA concentration <1 ng/mL at age 60, no further screening is recommended ... Screening men with a PSA level of 1-2 ng/mL is an individual decision to be based on a discussion between patient and doctor."

In the U.S., guidelines for PSA screening vary, with one group recommending against routine screening and another limiting "routine" screening to those aged 55 to 69.

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